title: Medical care transition planning and dental care use for youth with special health care needs during the transition from adolescence to young adulthood: a preliminary explanatory model.
abstract: The aims of the study were to test the hypotheses that youth with special health care needs (YSHCN) with a medical care transition plan are more likely to use dental care during the transition from adolescence to young adulthood and that different factors are associated with dental utilization for YSHCN with and YSHCN without functional limitations. National Survey of CSHCN (2001) and Survey of Adult Transition and Health (2007) data were analyzed (N = 1,746). The main predictor variable was having a medical care transition plan, defined as having discussed with a doctor how health care needs might change with age and having developed a transition plan. The outcome variable was dental care use in 2001 (adolescence) and 2007 (young adulthood). Multiple variable Poisson regression models with robust standard errors were used to estimate covariate-adjusted relative risks (RR). About 63 % of YSHCN had a medical care transition plan and 73.5 % utilized dental care. YSHCN with a medical care transition plan had a 9 % greater RR of utilizing dental care than YSHCN without a medical care transition plan (RR 1.09; 95 % CI 1.03-1.16). In the models stratified by functional limitation status, having a medical care transition plan was significantly associated with dental care use, but only for YSHCN without functional limitations (RR 1.11; 95 % CI 1.04-1.18). Having a medical care transition plan is significantly associated with dental care use, but only for YSHCN with no functional limitation. Dental care should be an integral part of the comprehensive health care transition planning process for all YSHCN.
authors.affiliation: Department of Oral Health Sciences, School of Dentistry, University of Washington, Box 357475, Seattle, WA, 98195, USA, dchi@uw.edu.
authors.forename: Donald L
authors.initials: DL
authors.lastname: Chi
mesh_terms: D000293:Adolescent; D002648:Child; D002671:Child, Exceptional; D015331:Cohort Studies; D016001:Confidence Intervals; D003695:Delivery of Health Care / Q000458:organization & administration*; D003729:Dental Care / Q000379:methods*; D005260:Female; D019538:Health Care Surveys; D006285:Health Planning / Q000458:organization & administration*; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008962:Models, Theoretical; D015999:Multivariate Analysis; D016012:Poisson Distribution; D011787:Quality of Health Care; D012189:Retrospective Studies; D018570:Risk Assessment; D060305:Transition to Adult Care / Q000458:organization & administration*; D016896:Treatment Outcome; D014481:United States; D055815:Young Adult